小儿支气管哮喘合并肺炎支原体感染的免疫功能变化与临床意义

Changes of immune function in children with bronchial asthma complicated with mycoplasma pneumoniae infection and its clinical significance

目的探讨小儿支气管哮喘合并肺炎支原体(MP)感染的体液免疫与细胞免疫功能指标水平的变化,为其临床诊断与防治提供指导。方法选取苏州市吴江区儿童医院自2019年12月至2021年4月收治的120例支气管哮喘患儿作为观察组,按照血浆MP抗体(MP-IgM)表达水平分为MP-IgM阳性组(67例)和MP-IgM阴性组(53例),另选取同期行健康体检的儿童60例作为对照组,开展前瞻性研究。对比对照组和观察组研究对象的MP-IgM阳性组和MP-IgM阴性组患儿免疫球蛋白水平、T淋巴细胞亚群水平及1型辅助性T细胞/2型辅助性T细胞(Th1/Th2)比值。结果观察组患儿血清免疫球蛋白A(IgA)、免疫球蛋白G(IgG)及免疫球蛋白M(IgM)水平均显著高于对照组;MP-IgM阳性组显著高于MP-IgM阴性组;观察组患儿CD3+、CD4+百分比、CD4+/CD8+比值、Th1/Th2比值均显著低于对照组;且MP-IgM阳性组显著低于MP-IgM阴性组(均P<0.05)。结论支气管哮喘患儿多存在着免疫调节功能紊乱的表现,其中免疫球蛋白呈现出了异常升高的趋势,T淋巴细胞活化功能减弱,细胞免疫功能低下,且这种表现在合并MP感染患儿中更加显著。

Objective To explore the changes of humoral immune and cellular immune function indexes in children with bronchial asthma complicated with mycoplasma pneumonia(MP)infection,so as to provide guidance for its clinical diagnosis,prevention and treatment.Methods 120 children with bronchial asthma admitted to Wujiang District Children's Hospital of Suzhou from December 2019 to April 2021 were selected as the observation group.According to the expression level of plasma MP antibody(MP-IgM),they were divided into the MP-IgM positive group(67 cases)and the MP-IgM negative group(53 cases),and 60 children who underwent physical examination during the same period were selected as the control group to carry out a prospective study.Compared the MP-IgM positive group and the MP-IgM negative group of children with immunoglobulin levels,T lymphocyte subsets levels and T-helper lymphocyte type-1/T-helper lymphocyte type-2(Th1/Th2)ratio between the control group and the observation group.Results The levels of serum immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)of children in the observation group were significantly higher than those in the control group;ande the MP-IgM positive group was significantly higher than the MP-IgM negative group;the CD3+,CD4+percentage,CD4+/CD8+ratio,Th1/Th2 ratio of children in the observation group were significantly lower than those in the control group;and the MP-IgM positive group was significantly lower than the MP-IgM negative group(all P<0.05).Conclusion Most children with bronchial asthma have immunoregulatory dysfunction,immunoglobulins show an abnormally elevated trend,T lymphocyte activation function begins to weaken,and cellular immune function impaired,and this manifestation is more pronounced in children with bronchial asthma complicated with MP infection.